Lamotrigine treatment of bipolar disorder

Data from the first 500 patients in STEP-BD

Lauren B. Marangell, James M. Martinez, Terence A. Ketter, Charles L. Bowden, Joseph F. Goldberg, Joseph R. Calabrese, Sachiko Miyahara, David J. Miklowitz, Gary S. Sachs, Michael E. Thase, Melvin D. Shelton, Michael W. Otto, Andrew A. Nierenberg, R. Bruce Lydiard, James C Y Chou, Joshua Cohen, John Zajecka, Po W. Wang, Uriel Halbreich, Alan Gelenberg & 13 others Mark Rapaport, Marshall Thomas, Michael H. Allen, Rif S. El-Mallakh, Peter Hauser, Jayendra Patel, Kemal Sagduyu, Mark D. Fossey, William R. Yates, Laszlo Gyulai, Claudia Baldassano, Edward S. Friedman, Cheryl L. Gonzales

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective: To describe the frequency and correlates of lamotrigine therapy among the first 500 patients enrolled into the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study. Method: Systematic recording of psychiatric history and medication data at intake into the STEP-BD project. Results: Of the participants with bipolar disorder type I or II (n = 483), 77 (15.4%) were currently taking lamotrigine (mean dose: 258.12 mg/day) and 52 (10.4%) reported prior lamotrigine use. The groups were comparable with regard to duration of illness and mood state at study entry. Compared with participants who had never taken lamotrigine, those currently treated with lamotrigine were significantly more likely to have a prior history of rapid cycling (62.5% vs. 43.1%; p < 0.01) and an antidepressant-induced switch to (hypo)mania (49.3% vs. 33.3%; p < 0.01). In contrast, only 16.9% of lamotrigine-treated participants were taking an antidepressant at study intake, as compared with 29.1% of participants with no history of lamotrigine therapy (p < 0.03). Conclusions: While noting the limitations of a cross-sectional assessment, these data suggest that lamotrigine therapy was commonly used in these academic centers for patients with bipolar disorder several years before it was recommended in the American Psychiatric Association practice guidelines, particularly in patients with a history of rapid cycling or antidepressant-induced mania.

Original languageEnglish (US)
Pages (from-to)139-143
Number of pages5
JournalBipolar Disorders
Volume6
Issue number2
DOIs
StatePublished - Apr 2004

Fingerprint

Bipolar Disorder
Antidepressive Agents
Therapeutics
lamotrigine
Practice Guidelines
Psychiatry

Keywords

  • Anticonvulsant
  • Bipolar disorder
  • Depression
  • Lamotridge
  • Treatment

ASJC Scopus subject areas

  • Neuroscience(all)
  • Neuropsychology and Physiological Psychology

Cite this

Marangell, L. B., Martinez, J. M., Ketter, T. A., Bowden, C. L., Goldberg, J. F., Calabrese, J. R., ... Gonzales, C. L. (2004). Lamotrigine treatment of bipolar disorder: Data from the first 500 patients in STEP-BD. Bipolar Disorders, 6(2), 139-143. https://doi.org/10.1111/j.1399-5618.2004.00098.x

Lamotrigine treatment of bipolar disorder : Data from the first 500 patients in STEP-BD. / Marangell, Lauren B.; Martinez, James M.; Ketter, Terence A.; Bowden, Charles L.; Goldberg, Joseph F.; Calabrese, Joseph R.; Miyahara, Sachiko; Miklowitz, David J.; Sachs, Gary S.; Thase, Michael E.; Shelton, Melvin D.; Otto, Michael W.; Nierenberg, Andrew A.; Lydiard, R. Bruce; Chou, James C Y; Cohen, Joshua; Zajecka, John; Wang, Po W.; Halbreich, Uriel; Gelenberg, Alan; Rapaport, Mark; Thomas, Marshall; Allen, Michael H.; El-Mallakh, Rif S.; Hauser, Peter; Patel, Jayendra; Sagduyu, Kemal; Fossey, Mark D.; Yates, William R.; Gyulai, Laszlo; Baldassano, Claudia; Friedman, Edward S.; Gonzales, Cheryl L.

In: Bipolar Disorders, Vol. 6, No. 2, 04.2004, p. 139-143.

Research output: Contribution to journalArticle

Marangell, LB, Martinez, JM, Ketter, TA, Bowden, CL, Goldberg, JF, Calabrese, JR, Miyahara, S, Miklowitz, DJ, Sachs, GS, Thase, ME, Shelton, MD, Otto, MW, Nierenberg, AA, Lydiard, RB, Chou, JCY, Cohen, J, Zajecka, J, Wang, PW, Halbreich, U, Gelenberg, A, Rapaport, M, Thomas, M, Allen, MH, El-Mallakh, RS, Hauser, P, Patel, J, Sagduyu, K, Fossey, MD, Yates, WR, Gyulai, L, Baldassano, C, Friedman, ES & Gonzales, CL 2004, 'Lamotrigine treatment of bipolar disorder: Data from the first 500 patients in STEP-BD', Bipolar Disorders, vol. 6, no. 2, pp. 139-143. https://doi.org/10.1111/j.1399-5618.2004.00098.x
Marangell LB, Martinez JM, Ketter TA, Bowden CL, Goldberg JF, Calabrese JR et al. Lamotrigine treatment of bipolar disorder: Data from the first 500 patients in STEP-BD. Bipolar Disorders. 2004 Apr;6(2):139-143. https://doi.org/10.1111/j.1399-5618.2004.00098.x
Marangell, Lauren B. ; Martinez, James M. ; Ketter, Terence A. ; Bowden, Charles L. ; Goldberg, Joseph F. ; Calabrese, Joseph R. ; Miyahara, Sachiko ; Miklowitz, David J. ; Sachs, Gary S. ; Thase, Michael E. ; Shelton, Melvin D. ; Otto, Michael W. ; Nierenberg, Andrew A. ; Lydiard, R. Bruce ; Chou, James C Y ; Cohen, Joshua ; Zajecka, John ; Wang, Po W. ; Halbreich, Uriel ; Gelenberg, Alan ; Rapaport, Mark ; Thomas, Marshall ; Allen, Michael H. ; El-Mallakh, Rif S. ; Hauser, Peter ; Patel, Jayendra ; Sagduyu, Kemal ; Fossey, Mark D. ; Yates, William R. ; Gyulai, Laszlo ; Baldassano, Claudia ; Friedman, Edward S. ; Gonzales, Cheryl L. / Lamotrigine treatment of bipolar disorder : Data from the first 500 patients in STEP-BD. In: Bipolar Disorders. 2004 ; Vol. 6, No. 2. pp. 139-143.
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abstract = "Objective: To describe the frequency and correlates of lamotrigine therapy among the first 500 patients enrolled into the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) study. Method: Systematic recording of psychiatric history and medication data at intake into the STEP-BD project. Results: Of the participants with bipolar disorder type I or II (n = 483), 77 (15.4{\%}) were currently taking lamotrigine (mean dose: 258.12 mg/day) and 52 (10.4{\%}) reported prior lamotrigine use. The groups were comparable with regard to duration of illness and mood state at study entry. Compared with participants who had never taken lamotrigine, those currently treated with lamotrigine were significantly more likely to have a prior history of rapid cycling (62.5{\%} vs. 43.1{\%}; p < 0.01) and an antidepressant-induced switch to (hypo)mania (49.3{\%} vs. 33.3{\%}; p < 0.01). In contrast, only 16.9{\%} of lamotrigine-treated participants were taking an antidepressant at study intake, as compared with 29.1{\%} of participants with no history of lamotrigine therapy (p < 0.03). Conclusions: While noting the limitations of a cross-sectional assessment, these data suggest that lamotrigine therapy was commonly used in these academic centers for patients with bipolar disorder several years before it was recommended in the American Psychiatric Association practice guidelines, particularly in patients with a history of rapid cycling or antidepressant-induced mania.",
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AU - Bowden, Charles L.

AU - Goldberg, Joseph F.

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